Ciclopirox (Topical)

Ciclopirox is a topical medicine used to treat fungal infections in children and adults.

Overview

Ciclopirox is a prescription topical medicine primarily used to treat fungal infections. For the most part, common fungal infections can cause a great deal of discomfort. Some common signs of a fungal infection include itching, rashes and pain.

It is available under the US trade name Ciclodan, though other brands, like Loprox and Penlac, are also common. It is available in a number of topical formats, including creams, gels, lotions, nail lacquers and shampoos.

Condition(s) treated

  • Athlete's foot
  • Candida
  • Jock itch
  • Ringworm
  • Seborrheic dermatitis
  • Sun fungus
  • Dandruff

Type of medicine

  • Anti-fungal agent

Side effects

Ciclopirox can cause some side effects to occur, including:

  • Excessive dandruff in cases of seborrheic dermatitis
  • Migraines and headaches, especially in sinus and allergy sufferers
  • Scalp irritations
  • Skin irritation or breakouts of rashes
  • Skin that feels oily to the touch

In some rare cases, ciclopirox may cause a skin disorder to develop.

Allergies

Ciclopirox could cause a serious and potentially fatal allergic reaction in a few patients. For this reason, doctors often query the medical history of patients, particularly relating to their hypersensitivity to medicines.

Some of the warning signs of a serious allergic reaction to ciclopirox include:

  • Burning sensation
  • Difficulty breathing
  • Edema
  • Excessive itching
  • Hives
  • Irregular heartbeat
  • Peeling skin
  • Tightness in the chest
  • Tingling sensation

If any of these symptoms occur, stop using ciclopirox and contact 911 right away. In a serious medical crisis, it helps to have a list of all medications and pre-existing conditions on hand for EMTs to review and respond appropriately. As a result, medical practitioners advise all patients to keep a medical bracelet or ID card containing this information.

Dosage

Ciclopirox is applied topically to the affected skin area where the fungus is present. The dose amounts vary from one patient to another. Generally speaking, the dose is based on the patient's age and underlying medical history. Other determinants of dosage include the medicinal strength of ciclopirox, as well as the length of treatment and times between each dose.

The following guide provides estimates of recommended doses and in no way replaces the prescription order provided to you by a medical practitioner. Do not stop treatment or adjust dosage unless you consult with your medical practitioner.

If you have questions or concerns about taking this medicine, schedule an appointment or consultation with your prescribing doctor or pharmacist before use.

Average doses of ciclopirox

For topical cream and lotion dosage forms, the general guidelines are as follows:

General fungal infection doses

For common fungal infections, the following doses of ciclopirox are prescribed in cream or lotion forms:

  • Adults: liberally apply to the affected areas twice daily
  • Children 10 and older: liberally apply to the affected areas twice daily
  • Children under 10: treatment varies

Note: For twice per day prescriptions of ciclopirox, the best times to use are after showering in the morning or directly before bed time.

Tubes are generally supplied in 15g, 30g or 90g sizes.

Seborrheic dermatitis fungal infection doses

The following doses are generally prescribed for seborrheic dermatitis affecting the surrounding skin areas:

  • Adults: liberally apply to the affected skin areas twice daily
  • Children 16 and older: liberally apply to the affected skin areas twice daily
  • Children under 16: treatment varies

The following doses apply to hair and scalp seborrheic dermatitis:

  • Adults: liberally apply 1tsp to the hair and scalp twice weekly for a duration of four weeks
  • Children 16 and older: liberally apply 1tsp to the hair and scalp twice weekly for a duration of four weeks
  • Children under 16: treatment varies

Note: For best results, the medicine should be left on the hair and scalp for up to three minutes before rinsing.

General nail fungal infection doses

Patients are advised to use the applicator brush included with the lacquer and apply the solution liberally to the affected nail or nails roughly eight hours after taking a bath. The treatment can last for up to six months and the nails should be trimmed periodically during the course of treatment in order to remove the affected parts of the nail.

To promote healthy nail growth, your medical provider will complete a number of routine checkups.

Prolonged treatment

Some patients require a longer treatment period if symptoms do not go away quickly. In these cases, the plan could last for several weeks.

Missed doses

When commencing any medical treatment, patients are advised to create a schedule so that they have the treatment at the same time each day and stick to it. If you do happen to miss a dose of ciclopirox, take it as soon as you remember. However, to reduce the side effects of the medicine, do not double the dosage within a 24 hour period. This means that if the time for the next dose is coming close, skip the missed dose and restart the normal schedule at the next prescribed time.

Medication strengths

The different topical routes available come with varying strengths of ciclopirox olamine. For example, ciclopirox is supplied in the following strengths:

  • Creams, lotions, and gels contain 0.77% of ciclopirox olamine
  • Nail lacquers contain 8% of ciclopirox olamine
  • Shampoos contain 1% of ciclopirox olamine

Interactions

No notable drug interactions have been found to cause contraindications with ciclopirox. However, it is still important for patients to tell their doctor about any current or recent medications they are using, including over the counter treatments. This is particularly important for medications that are intended to treat fungal infections, as these could affect the way ciclopirox works or worsen the potential side effects.

Also, tell your doctor if you take vitamins or herbal supplements, or use tobacco or alcohol products on a regular basis.

Warnings

It is important for patients to read warning labels that come with prescribed packages of ciclopirox before use. Some of the most common warnings outlined on this label include:

Listing all allergies

Tell your medical practitioner if you've ever had any hypersensitivities to medicines, food, dye or preservative products.

Follow the treatment plan

In order to ensure that ciclopirox works properly to eliminate the underlying fungal infection, every effort should be taken to adhere to the treatment schedule, for the full length of the treatment. It is not uncommon for the symptoms of a fungal infection to clear up within days of use. However, it is critical that patients adhere to the treatment plan for best results and to prevent a reoccurrence of the infection.

Worsening symptoms

If the infection does not get better within 15 - 30 days or the symptoms get worse, stop the treatment of ciclopirox and contact your medical provider for help. An alternate solution may be required if the fungus is unresponsive to ciclopirox.

Avoid contact with the eyes

Ciclopirox could cause eye irritations. If the medicine accidentally gets into the eyes, rinse under warm running water and consult a medical provider for help.

Skin irritation

Ciclopirox may cause the skin to become irritated. Most symptoms subside with time, but if you experience alarming reactions, such as those listed below, seek medical help right away. These could be signs of a severe allergic reaction to ciclopirox:

  • Burning sensations
  • Incessant itching
  • Oozing skin
  • Redness
  • Skin that blisters
  • Swelling

Treating nail fungus with ciclopirox

Topical treatments of ciclopirox usually work hard and fast to eliminate underlying fungal infections. For nail applications, however, the treatment can last months. In conjunction with the nail lacquer of ciclopirox prescribed, follow up visits to a medical worker may be required to remove any leftover nail that is still infected.

Reducing the risks of reinfection

Fungal infections can sometimes be hard to kick. Even with initial treatment success, the infection could possibly return based on a number of factors. To reduce the risk of reoccurrence, follow the below tips:

  • Hand washing: to prevent the transmission of bacteria, viruses or fungal infections, doctors recommend frequent hand washing. This must be done several times per day, particularly after using the bathroom and when other public surfaces have been touched.
  • Keep cool and dry:after bathing or swimming, patients can reduce the risk of developing fungal infections, such as candida, by keeping all areas of the body dry and cool at all times.
  • Do not apply dressings: when using lotion, cream and gel topical solutions of ciclopirox, do not cover with a bandage or other dressing. This could exacerbate the condition and cause the skin to become more irritated. Leave as it is, always taking measures to keep the skin cool and dry.

Tips for preventing ringworm in the groin:

People who are susceptible to fungal infections should:

  • Wear cool cotton underwear' medical specialists often advise patients to wear loose-fitting underwear that is made from cotton, as heat offers a perfect breeding ground for fungus and bacteria.
  • Avoid perfumes and cosmetics with additives'certain products can kick skin irritation into overdrive, leaving room for fungi and bacteria to take hold in chafed or bruised areas of the skin. As such, medical practitioners recommend using additive free and clear powders or cosmetics on the groin; try ones created just for hypersensitive skin. Absorbent powders like talcum, for example, are great for keeping the groin area cool and dry throughout the day.

Tips for preventing foot ringworm and athlete's foot

Similarly, the foot areas should be:

  • Dried thoroughly' after each bath or swim session, use a towel to dry all areas of the feet, including in between the toes.
  • Dressed properly'nce again, cotton socks are a more favorable choice compared to materials, like wool or rayon, which trap heat more easily. Patients who are susceptible to athlete's foot should try to change this undergarment every day and wash each pair of soiled socks in piping hot water. Moreover, to reduce heat traps, opt for sandals instead of closed toe shoes whenever possible.
  • Treat with an absorbent powde' to maximize the fungi-fighting effects of ciclopirox, an absorbent powder, such as talcum, can be applied between treatments for best results.

Storage

Almost all versions of ciclopirox topical medicines, including gels, creams, shampoos and lotions, can be stored at room temperatures of 20°C to 25°C (68°F to 77°F).

Keep out of areas that are known to experience heat, moisture, or direct sunlight, as these temperature extremes could affect the quality of the medicine and how it works.

The nail lacquer is flammable and should not be placed in areas with excess heat.

In addition, follow best practices for storing medicines out of the reach of children and pets. In the event of misuse, call the American Association of Poison Control Centers at (800) 222-1222.

Summary

Ciclopirox is classified as a broad spectrum anti-fungal agent used to treat a wide variety of fungal infections throughout the body. This includes on the nails or in the groin, hair and scalp, or on the skin. Some common examples of conditions it is used to treat are ringworm, athlete's foot and candida.

This medicine is only accessible through a prescription from a certified medical professional. It may be prescribed as a gel, shampoo, cream or lotion, depending on the underlying condition being treated.

Ciclopirox is intended for dermatologic use only. It should never be swallowed or placed into the eyes. In the event of oral consumption or eye irritation, seek medical help right away.